anti-psychotics Flashcards
dopaminergic drugs: explain how drugs targeting the dopaminergic system are utilized in the treatment of schizophrenia, which symptoms they treat and discuss the side effects associated with these treatments
2 first generation antipsychotics for schizophrenia (main side effect is extrapyramidal (EPS))
chlorpromazine, haloperidol
primary mechanism of action of chlorpromazine in schizophrenia
D2 receptor antagonism
high incidence side effects of chlorpromazine
anti-cholinergic (affects histamine receptors as well), especially sedation
low incidence side effects of chlorpromazine
extrapyramidal side-effects (EPS)
mechanism of action of haloperidol
potent D2 receptor antagonist (50% more potent than chlorpromazine)
when do therapeutic effects of haloperidol develop
over 6-8 weeks, with little impact on negative symptoms
high incidence side effects of haloperidol
extrapyramidal side-effects (EPS)
4 second generation antipsychotics (side effects are metabolic or cardiac)
clozapine (most effective antipsychotic as only drug to show efficacy in treatment resistant schizophrenia and negative symptoms), risperidone, quetiapine, aripiprazole
mechanism of action of clozapine
potent antagonist of 5HT-2A receptors
4 side effects of clozapine
fatal neutropenia, agranulocytosis, myocarditis, weight gain
mechanism of action of risperidone
potent antagonist of 5-HT2A and D2 receptors
side effects of risperidone compared to other atypical antipsychotics
more extrapyramidal side-effects (EPS) and hyperprolactinaemia (EPS unusual for second generation antipsychotics)
mechanism of action of quetiapine
potent antagonist of H1 receptors
side effects of quetiapine compared to other antipsychotics
lower incidence of extrapyramidal side-effects (EPS)
mechanism of action of aripiprazole
partial agonist of D2 and 5HT-1A receptors (if too much acitivty, causes inhibition, and if too little activity, increases activity; in practice no more efficacious than typical antipsychotics)
